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Cysts of the ligamentum flavum are often linked to ischemic conditions: A morphological study.

Ayano MatsunagaMariko SaitoKaya IjiriMotohiro TsuchiyaAkimasa YasudaKazuya KitamuraSho OgataKazuhiro ChibaSusumu Matsukuma
Published in: Pathology international (2024)
"Cysts of the ligamentum flavum (cysts-LF)" is the term for non-neoplastic cystic lesion involving LF. The aim of the present study was to elucidate the histopathological characteristics and pathogenesis of "cysts-LF". Herein, we defined cysts-LF as spinal cysts containing degenerative LF components. From archival cases, we investigated 18 symptomatic cysts-LF surgically removed from 18 patients (13 males and five females; median age 68.5 years [range, 42-86 years]). The elastic fibers of LF components in the wall were separated and/or torn, and cyst walls were accompanied by chondroid metaplasia (17 cases), myxoid changes (13 cases), ossification (11 cases), amyloid deposits (14 cases), hemosiderosis (six cases), granular/smudgy calcification (four cases), synovial cell linings (three cases), and severe inflammatory infiltrates (one case). These histologic features of our cysts-LF were shared by previously reported "cysts-LF." Fourteen cysts-LF demonstrated vascular stenosis/occlusion, and eight showed thick hyalinized vessels, suggesting local circulatory insufficiency. Eight cases (44%) exhibited lipomembranous fat necrosis, accompanied by hyalinized vascular changes (p = 0.003). Ischemic conditions were observed in nearly half of the present cysts-LF, and may be one of the main contributing factors for the formation of cysts-LF, via degeneration and cystic changes in the LF.
Keyphrases
  • adipose tissue
  • end stage renal disease
  • oxidative stress
  • spinal cord
  • peritoneal dialysis
  • preterm infants
  • ejection fraction
  • single cell
  • cell therapy
  • extracorporeal membrane oxygenation
  • brain injury
  • drug induced